In most high-income countries, the main reasons that children are in alternative care are family abuse and neglect. In China, due to the absence of an effective child protection system, very few children receive alternative care for these reasons. In China, children receiving alternative care provided by the state are mainly children without parents. Most children who are orphaned live with extended family. If they become state wards, the child welfare institution tries to arrange adoption. Otherwise, the most common forms of alternative care are institutional care or foster care.

This chapter describes who is in care and the forms of care. These questions are important because the way in which alternative care is organized affects the childhood experience of the young people and their future opportunities. The qualities of the alternative care that they encounter might contribute to their current and future social inclusion by addressing and anticipating their current and potential disadvantages, for example, by forming family connections in adoptive or foster families. Alternatively, the arrangements might aggravate their disadvantages by layering further experiences of social exclusion, such as segregation from other children and families throughout their childhood.

Children in state care

Alternative care in China includes extended family care, adoption, institutional care and foster care. The first two forms of care are not normally referred to as alternative care in high-income countries. The data released by the Chinese Ministry of Civil Affairs (MCA) in 2005 based on a census of orphans in China are the most complete data available about alternative care in the country. Although the data were collected more than a decade ago, the types of alternative care have not changed. Excluding adoption, when children become part of a new family, most children in alternative care are cared for in their extended family (kinship care, 62.3%), followed by foster care (12.6%) and institutional care (11.8%).

In most rural areas of China, kinship is still central to social life. Extended families, particularly those in the patrilineal line, remain the central social relationship among many farming communities. Following tradition, children have the surname of their father and inherit the paternal line.